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Journal of Endodontics Feb 2024The aim of this study was to ascertain the current trends in regenerative endodontic procedures (REPs) among clinicians, including case selection criteria and clinical...
INTRODUCTION
The aim of this study was to ascertain the current trends in regenerative endodontic procedures (REPs) among clinicians, including case selection criteria and clinical protocols.
METHODS
An online questionnaire consisting of provider demographics, case selection criteria for REPs, and clinical protocols was made available to members of the American Association of Endodontists and members of the Endolit website. Data were analyzed using the Fisher exact test.
RESULTS
Two hundred seventy-two responses were analyzed (64.6% were men and 34.7% were women). Of those, 44.5% of respondents practiced in the United States, and 55.5% practiced outside of the Unites States. Most respondents (85.4%) reported performing REPs in their practice, and 92.2% were using sodium hypochlorite as one of their disinfecting irrigants. Calcium hydroxide was the most commonly used intracanal medicament (68.4%), and the majority of respondents use a blood clot alone as the scaffold (73.5%). Most (93%) of the providers reported using a bioceramic material for coronal capping. Practitioners outside the United States were found to be more likely to use adjunctive irrigation activation (P = .003). Younger practitioners preferred REPs over apexification (P = .01). Practitioners outside the United States were more likely to perform an REP in 1 visit (P = .006). Men were found to be more likely to always instrument the canal walls (P = .031). Women were found to be more likely to use manual irrigant activation, whereas men were more likely to use sonic activation (P = .043).
CONCLUSIONS
There is significant heterogeneity within REPs regarding case selection and clinical protocol. Notable differences were observed from the reported findings of REPs from 5 years ago.
Topics: Male; Humans; Female; Regenerative Endodontics; Endodontists; Sodium Hypochlorite; Surveys and Questionnaires; Internet; Dental Pulp Necrosis; Endodontics
PubMed: 38013150
DOI: 10.1016/j.joen.2023.11.013 -
Journal of Dentistry Oct 2023Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine...
OBJECTIVES
Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine how often these dentists provide specific dental procedures.
METHODS
Dentists completed a questionnaire when they enrolled in the Network about their demographic and training characteristics and characteristics of their practices and patients. Dentists also reported the frequency of providing specific dental procedures. Data were analyzed using descriptive statistics.
RESULTS
Of 4,483 dentists in active clinical practice, 34% identified as females, 70% as white, and 73% as general dentists. Most dentists practiced in large metropolitan areas (87%) and in solo or small practices (72%). On average, they reported about one-half of their patients were children or older adults, a third were from historically underrepresented racial and ethnic groups, and one-quarter were covered by public insurance. Most dentists routinely performed restorations and fixed prosthetics (78%), extractions (59%), removable (44%) and implant (40%) prosthetics, and endodontics on incisor and premolar teeth (44%).
CONCLUSIONS
Dentists participating in the National Dental PBRN have much in common with dentists at large. The network has a broad representation of dentists, practice types, patient populations, and treatments offered, including diversity regarding race/ethnicity, gender, insurance, and geography of its practitioners and patients.
CLINICAL SIGNIFICANCE
Characteristics of National Dental PBRN dentists suggest that a broad range of dentists is interested in participating in national-level research studies, thereby enabling an array of clinical study settings and topics that can optimize the generalizability of study findings.
Topics: Female; Child; Humans; United States; Aged; Surveys and Questionnaires; Dental Care; Dentists; Practice Patterns, Dentists'; Dental Research
PubMed: 37572986
DOI: 10.1016/j.jdent.2023.104653 -
International Journal of Dental Hygiene Aug 2023The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals. (Review)
Review
OBJECTIVE
The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals.
METHODS
Three databases were utilized from September 2019 to November 2021 in addition to hand-searching specific journals and reference lists. Research articles that examined pinch force generation in dental professionals during scaling with manual instruments only were included. Bias was assessed in the individual articles.
RESULTS
Six research articles were included with sample populations that varied from 12 to 24 participants. Four articles evaluated instrument designs in relation to pinch force generation during scaling by dental professionals. Two articles evaluated the clinicians' experience levels and the impact on pinch force generation. Results of three articles revealed instruments with large diameters and low weights produced the least amount of pinch force (p < 0.05). Additionally, two articles found instruments with a round, tapered shape produced less pinch force and instrument handles made of silicone produced higher pinch strength post-scaling (p < 0.05). One study indicated instrument designs associated with modified scaling techniques may reduce thumb and index finger pinch force (p < 0.05).
CONCLUSION
The findings from this review indicate weak evidence for instrument choices to reduce pinch force during scaling. Dental professionals should consider lightweight and large diameter instruments for manual scaling. Clinicians may also want to consider round, tapered handles and instrument designs with modified scaling techniques. This systematic review further identified the need for clinical research studies with rigorous research designs that examine the ergonomic impacts of instrument designs.
Topics: Humans; Research Design; Dental Scaling; Hand; Ergonomics; Dentists
PubMed: 36524311
DOI: 10.1111/idh.12649 -
Advances in Clinical and Experimental... Nov 2023Halitosis (fetor ex ore, malodor, bad breath) is defined as an unpleasant odor coming from the oral cavity, regardless of the cause: local or systemic. It affects 22-50%...
BACKGROUND
Halitosis (fetor ex ore, malodor, bad breath) is defined as an unpleasant odor coming from the oral cavity, regardless of the cause: local or systemic. It affects 22-50% of the population worldwide, leading to a significant decrease in the overall quality of life, and can have oral and extra-oral etiologies. There is an increased interest in the management of halitosis.
OBJECTIVES
This study aims to evaluate the patient-dentist communication on halitosis, the dentists' knowledge about the management and etiology of halitosis, and the treatment options used by dentists who practice in Poland and Lebanon.
MATERIAL AND METHODS
An online questionnaire was sent to both Lebanese and Polish dentists using Google Forms (Google LLC, Mountain View, USA). In total, 205 dentists completed the questionnaire, of which 100 practiced in Poland (group P) and 105 practiced in Lebanon (group L). A multivariate analysis was conducted to determine differences between both groups and to identify parameters that could influence a dentist's management of halitosis.
RESULTS
According to the questionnaire, 86% of group P members and 65.7% of group L members reported communicating with patients about halitosis. Regarding the knowledge of halitosis, 78% of dentists in group P and 85.7% of dentists in group L reported that there is a classification for halitosis. A significant majority of dentists in both groups revealed not having any tool to measure halitosis (67.6% and 68% from group P and group L, respectively).
CONCLUSIONS
This study confirms the need for improved communication skills in Polish and Lebanese dentists, as well as for education on the subject among dentists in both countries, and for standardization in diagnosis, treatment modalities and management of halitosis.
Topics: Humans; Halitosis; Poland; Quality of Life; Surveys and Questionnaires; Dentists
PubMed: 37326577
DOI: 10.17219/acem/161813 -
Periodontology 2000 Apr 2024Liquid biopsy is a noninvasive diagnostic technique used for monitoring cancer utilizing specific genetic biomarkers present in bodily fluids, such as blood, saliva, or... (Review)
Review
Liquid biopsy is a noninvasive diagnostic technique used for monitoring cancer utilizing specific genetic biomarkers present in bodily fluids, such as blood, saliva, or urine. These analyses employ multiple biomolecular sources including circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and exosomes (that contain DNA fragments) to detect genetic biomarkers that can predict, disclose, and/or monitor cancers. Levels of these biomarkers can inform on the presence of cancer, its genetic characteristics, and its potential treatment response and also provide predictive genetic predisposition information for specific cancers including oral squamous cell carcinomas (OSCC). Liquid biopsies can aid cancer management as they offer real-time dynamic information on the response to say chemotherapy or radiotherapy and recurrence following surgical excision. Unlike traditional tissue biopsies, which are invasive with a degree of morbidity and require specific tumor location sampling, liquid biopsies are noninvasive and can be repeated frequently. For oral squamous cell carcinoma, on which this review focuses, liquid biopsy of blood or saliva can be valuable in predicting susceptibility, providing early detection, and monitoring the disease's progression and response to therapy. This review gives a general narrative overview of the technology, its current medical usage, and advantages and disadvantages compared with current techniques and discusses a range of current potential biomarkers for disclosing OSCC and predicting its risk. Oral squamous cell carcinoma is all too often detected in the late stages. In future, liquid biopsy may provide an effective screening process such that cancers including OSCC will be detected in the early stages rather than later when prognosis is poor and morbidity and debilitation are greater. In this screening process, periodontists and hygienists have a critical role in that they are adept in examining mucosa, they see patients with shared risk factors for periodontitis and OSCC, namely smoking and poor oral hygiene, and they see patients frequently such that OSCC examinations should be a routine part of the recall visit. With this additional screening manpower, oral medicine and oral surgery colleagues will detect OSCC earlier and this coupled with new techniques such as liquid biopsy may greatly decrease global morbidity in OSCC.
PubMed: 38676371
DOI: 10.1111/prd.12567 -
Current Osteoporosis Reports Aug 2023Osteoporosis ranks high among morbidities in the elderly as it is a natural process to lose bone, making them susceptible to fractures from minor falls. The cost of... (Review)
Review
PURPOSE OF REVIEW
Osteoporosis ranks high among morbidities in the elderly as it is a natural process to lose bone, making them susceptible to fractures from minor falls. The cost of managing these patients is staggering. The fractures can be prevented with better care of the elderly, and by treating the major predisposing factor, osteoporosis. Clinicians and scientists, in general, constantly look for early diagnostic and prognostic indicators for osteopenia and osteoporosis to proactively prevent fractures. Dental panoramic radiography (DPR) is a rotational pantomography used for identifying dental pathology in patients. Early signs of osteopenia and osteoporosis can be identified in DPR. The usefulness of notable jaw changes in DPR to predict osteopenia and osteoporosis is still evolving as more studies continue to delve into this concept. The purpose of this review is to present advances made in the practical application of DPR for predicting early onset of osteopenia and osteoporosis.
RECENT FINDINGS
Dental panoramic radiography, a form of tomography commonly used by dental practitioners, has been the standard of care for decades for detecting dento-alveolar pathology. Several technological advancements have taken place with respect to the use of DPR. These include conversion from plain film to digital radiography, advancements in the manufacture of flat panel detectors, and accurate imaging of the layers of mandible and maxilla that has become possible with appropriate patient positioning within the focal trough of the machine. Improvements in the software infrastructure make it easier to view, enhance, and save the radiographic images. The radiographic appearance of the trabecular bone within the mandible and indices measured from the dental panoramic radiographs focusing on the inferior cortex of the mandible are considered useful tools for identifying asymptomatic individuals with osteoporosis or at risk for developing osteoporosis. These indices apparently correlate with risks of fragility fractures of osteoporosis in other parts of the body. Dental panoramic radiography (DPR) is a commonly used radiographic procedure in dentistry for evaluation of teeth and associated maxillofacial structures. The evaluation of the inferior border of the mandible for reduction or loss of cortical thickness and evaluation of the trabecular bone within the mandible are helpful markers for early signs of osteopenia to identify patients at risk for osteoporosis. This review focused on research advancements on practical application of DPR in early identification of osteopenia and osteoporosis.
Topics: Aged; Humans; Bone Density; Bone Diseases, Metabolic; Dentists; Fractures, Bone; Osteoporosis; Professional Role; Radiography, Panoramic
PubMed: 37382808
DOI: 10.1007/s11914-023-00807-5 -
Community Dentistry and Oral... Dec 2023This study aimed to understand the perspectives of dentists towards the Montreal-Toulouse model, an innovative approach that encompasses person-centredness and social...
OBJECTIVES
This study aimed to understand the perspectives of dentists towards the Montreal-Toulouse model, an innovative approach that encompasses person-centredness and social dentistry. This model invites dentists to take three types of actions (understanding, decision-making, intervening) on three overlapping levels (individual, community, societal). This study aimed to understand (a) How dentists perceived the Montreal-Toulouse model as a framework for the practice of dentistry and (b) What parts of this model they were ready to adopt in their own practice.
METHODS
A qualitative descriptive study was conducted based on semi-structured interviews with a sample of dentists in the Province of Quebec, Canada. A combination of maximum variation and snowball sampling strategies was employed and 14 information-rich participants were recruited. The interviews were conducted and audio-recorded through Zoom and lasted approximately 1 h and a half. The interviews were transcribed verbatim and thematically analysed through a combination of inductive and deductive coding.
RESULTS
The participants explained they valued person-centred care and tried to put the individual level of the Montreal-Toulouse model into practice. However, they expressed little interest in the social dentistry aspects of the model. They acknowledged not knowing how to organize and conduct upstream interventions and were not comfortable with social and political activism. According to them, advocating for better health-related policies, while a noble act, 'was not their job'. They also highlighted the structural challenges that dentists face in fostering biopsychosocial approaches such as the Montreal-Toulouse model.
CONCLUSIONS
To promote the Montreal-Toulouse model and empower dentists to address social determinants of health, an educational and organizational 'paradigm shift' towards social accountability might be necessary. Such a shift requires curricular modifications and reconsidering traditional teaching approaches in dental schools. Moreover, dentistry's professional organization could facilitate dentists' upstream actions through proper resource allocation and openness to collaboration with them.
Topics: Humans; Dentists; Quebec; Canada; Qualitative Research; Dentistry; Attitude of Health Personnel
PubMed: 37042424
DOI: 10.1111/cdoe.12859 -
American Journal of Orthodontics and... Sep 2023Transverse occlusal plane (TOP) should be parallel to the true horizontal lines of the face (ie, the interpupillary line [IP] and commissural line [CL]). This study...
INTRODUCTION
Transverse occlusal plane (TOP) should be parallel to the true horizontal lines of the face (ie, the interpupillary line [IP] and commissural line [CL]). This study aimed to investigate the opinions of laypersons, orthodontists, and oral and maxillofacial surgeons about the impact of imbalanced IP and CL on facial attractiveness.
METHODS
We used a symmetrical face image as the reference. Then, using Photoshop software, we constructed the following 6 photographs: TOP roll relative to CL and IP (3° and 6°) with parallelism of CL and IP, CL roll relative to TOP and IP (3° and 6°) with parallelism of TOP and IP, TOP and CL roll relative to IP (3° and 6°). Consequently, the participants rated the photographs on the basis of their attractiveness. Kruskal-Wallis and Mann-Whitney U tests were used to compare the ratings.
RESULTS
One hundred thirty-one laypersons, 22 orthodontists, and 20 surgeons participated in this study. It was found that 51.1% of laypersons, 86.4% of orthodontists, and 70% of surgeons selected the reference photograph as the most beautiful, followed by the photograph with a 3° roll of CL relative to TOP, with parallelism of TOP and IP (29% of laypersons, 31.8% of orthodontists, and 35% of surgeons).
CONCLUSIONS
Most participants selected the reference photograph as the most beautiful and realized a roll in the horizontal planes up to 3°. The parallelism of the esthetic line of dentition relative to interpupillary is preferred over its parallelism relative to CL.
Topics: Humans; Dental Occlusion; Orthodontists; Oral and Maxillofacial Surgeons; Attitude of Health Personnel; Esthetics, Dental; Perception; Smiling
PubMed: 36967313
DOI: 10.1016/j.ajodo.2023.02.011 -
BMC Oral Health Dec 2023One of the main clinical features of Sjögren's Syndrome is oral dryness, which is associated with an increased risk of oral diseases and a lower oral life quality....
BACKGROUND
One of the main clinical features of Sjögren's Syndrome is oral dryness, which is associated with an increased risk of oral diseases and a lower oral life quality. Dentists have a key role to play in the Sjögren's Syndrome diagnosis and specific management. In parallel, many patients rely on patient associations, which offer opportunities for members to seek information about their disease and share their experiences. We aimed to evaluate patients experience with dry mouth and the importance of dentists in Sjögren's Syndrome diagnosis and its management.
METHODS
We carried out a cross-sectional survey in 2020 based on a questionnaire drafted in collaboration with clinicians specializing in Sjögren's Syndrome and patient members of a patient association. The survey consisted of 27 questions divided into the six sections: the patient's profile, their experience with dry mouth and treatments used to manage, characteristics of experienced oral-health problems, effects of dry mouth and its consequences on the quality of life, evaluation of the dentist role in the screening of Sjögren's Syndrome, and its management by the dentist. Recruitment was carried out via the patient association's newsletter, website, and social networks. Sjögren's diagnosis was self-reported.
RESULTS
One thousand four hundred fifty-eight patients fully responded to the survey. Most respondents were women over 50 and were mainly concerned with primary Sjögren's Syndrome. Overall, 86.97% of respondents reported experiencing frequent or constant dry mouth and 69.01% declared having had oral problems (candidiasis, oral pain, loss or alteration of taste, bad breath, gastro-esophageal reflux). We found a positive correlation between the frequency of dry mouth and each of these disorders and between the frequency of dry mouth and alterations in life quality dimensions. Finally, 74.9% of patients did not report having dry mouth to their dentist prior to being diagnosed with Sjögren's Syndrome and 58% had not been informed about the oral risks associated with it by their dentist and sought information themselves or from their physician.
CONCLUSIONS
We confirm the significant consequences of dry mouth on oral quality of life, as well as its association with oral health problems. Sjögren's Syndrome screening by dentists should be increased, as well as prevention of the associated oral health risks.
Topics: Humans; Female; Male; Sjogren's Syndrome; Quality of Life; Cross-Sectional Studies; Xerostomia; Dentists; Patient Reported Outcome Measures
PubMed: 38102574
DOI: 10.1186/s12903-023-03727-z -
European Journal of Orthodontics Jul 2023To assess the changes in compliance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines for randomized controlled trials (RCTs) in four orthodontic...
OBJECTIVES
To assess the changes in compliance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines for randomized controlled trials (RCTs) in four orthodontic journals. To assess whether reporting of randomization, concealment, and blinding has improved.
METHODS
Electronic hand searching was undertaken to identify orthodontic RCTs published in four orthodontic journals from January 2016 to June 2017 (T1) and from January 2019 to June 2020 (T2). The journals were the American Journal of Orthodontics and Dentofacial Orthopaedics (AJO-DO), Angle Orthodontist (AO), European Journal of Orthodontics (EJO), and Journal of Orthodontics (JO). Each item on the CONSORT checklist was scored as either reported, not reported, or not applicable for each paper reporting an RCT.
RESULTS
The study included 69 papers reporting an RCT published in T1 and 64 RCTs published in T2. The median CONSORT score in T1 was 48.7% (interquartile range [IQR] 27.6%, 68.6%) and 67% in T2 (IQR 43.9%, 79.5%). This increase was statistically significant (P = 0.001) and largely attributable to improved reporting in AO (P = 0.016) and EJO (P = 0.023). Reporting did not change significantly in AJO-DO (P = 0.13) or in JO (P = 1.0). Reporting of random allocation sequence generation (OR 2.09; 95% CI 1.01, 4.29) and concealment of allocation (OR 2.27%, 95% CI 1.12, 4.57) were significantly higher in T2 compared with T1. Reporting of blinding did not change significantly.
CONCLUSION
Overall reporting of CONSORT items in reports of orthodontic RCTs published in the AJO-DO, AO, EJO, and JO, improved significantly from 2016-17 to 2019-20. This could be improved further by authors, journal referees, and editors adhering to the guidelines.
Topics: Humans; Orthodontics; Orthodontists; Checklist; Research Design; Dental Care
PubMed: 37253055
DOI: 10.1093/ejo/cjad007